Inquirer Editorial: Better to expand Medicaid

MICHAEL BRYANT / Staff (MICHAEL BRYANT / Staff)

Posted: September 20, 2013

It has been nearly six months since Gov. Corbett changed his tune a bit about receiving a few billion federal dollars in Obamacare subsidies to plug holes in Pennsylvania's health-care safety net. Yet the governor remains a long way from delivering on the new goal he announced Monday of giving all Pennsylvanians "access to quality and affordable health care."

Many doubt that his plan to use federal Medicaid dollars to subsidize private insurance policies for 520,000 uninsured Pennsylvanians will gain required federal approval. Critics who have already taken to calling Corbett "One-term Tom" are right to wonder whether the governor's Medicaid proposal is just a political stalling tactic.

Corbett's track record on social programs offers little reason for optimism. Since its first month in power, the Corbett administration has busied itself with discussions of ideas to close widening gaps in health coverage and cash aid for the state's neediest, including 93,000 children who have been tossed off the rolls of both the joint state-federal Children's Health Insurance Program and Medicaid.

Earlier, Corbett was a spirited combatant in failed, Republican-led efforts nationally to scuttle Obamacare - a rear-guard campaign still firing passions among tea-party faithful. At least, that long, twisted road led Corbett to the right place, with his declaration Monday that he's finally ready to propose terms under which the state would accept Obama-

care funds earmarked for expanding Medicaid to thousands of people, many in jobs that don't offer affordable health plans.

But apparently fearing what Grover Norquist and his Club for Growth buddies would think, Corbett wants current Medicaid recipients to pay a modest monthly premium, which is now barred by law, and fulfill a work-search requirement, which no other state has linked to health-care coverage.

Although the cost-sharing and job-hunting mandates could potentially help the state meet its budget bottom line, and boost the job-market efforts of individuals, they also could become the gotcha provisions that result in people losing their health coverage. Federal officials, taking the correct stance in saying they will try to work with Corbett, should press to avoid any of the obvious pitfalls in his plan.

While that process plays out, unfortunately, the status quo on health care under Corbett remains wholly unacceptable. The governor's seemingly endless deliberation over the right course for the state in expanding health-care coverage will almost certainly result in a further delay of a year or more in covering the uninsured.

That means the state will lose out on $1.6 billion in federal Medicaid dollars due to flow in 2014, plus another $2.8 billion in related economic impact to the state economy, including 30,000 new jobs generated from a straight-line expansion of Medicaid's rolls under Obamacare.

That potential gravy train further undermines Corbett's insistence that the state can't afford to expand Medicaid. Three independent studies show the return on expanding coverage would more than cover the cost. Such analyses helped drive a solid state Senate vote favoring a traditional expansion of Medicaid. It's not too late for Pennsylvania to take that assured course, even now.